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90746_BR_CRA_2009:2 12/9/09 9:43 AM Page 17

City of Big Rapids

AMENDED
Income Tax Form

**** A COPY OF THE ORIGINAL MUST ACCOMPANY THIS AMENDED RETURN****

Year Being Amended ____________________ Social Security
or Federal I.D.# ________________________________
Type of Return __________________________

Name ____________________________________________________

Current Address ____________________________________________

____________________________________________

Reason for Amendment (including calculations) __________________________________________________________

1. INCOME ............................................................................................ 1. ________________________
2. ADDITIONS TO INCOME .................................................................. 2. ________________________
3. SUBTRACTIONS FROM INCOME .................................................. 3. ________________________
4. IRA DEDUCTIONS ............................................................................ 4. ________________________
5. ADJUSTED INCOME (add line 1 & 2, Subtract 3 & 4) ................................ 5. ________________________
6. EXEMPTIONS.................................................................................... 6. ________________________
7. TAXABLE INCOME (Line 5 less line 6) .................................................. 7. ________________________
8. TAX .................................................................................................... 8. ________________________
Orginal Tax Paid __________________

Original Tax Refunded __________________

Additional Amount to be Refunded __________________

Additional Amount Owed __________________
Interest - .0001164 per day. __________________

Penalty - 1% per month not to exceed
25% of tax owed or a combined
minimum of $2.00 __________________

TOTAL TAX DUE __________________

**** A COPY OF THE ORIGINAL MUST ACCOMPANY THIS AMENDED RETURN****
I declare, under perjury, that the information on this return and attachments is true and complete
I authorize the CITY to discuss my DO NOT discuss
claim and attachments with my claim with my preparer
preparer
I declare, under penalty of perjury that this return is
Filer’s Signature __________________________________ Date ____________ based on all information of which I have knowledge.
PREPARER’S SIGNATURE & ADDRESS
Birthdate ________________________________________
Spouse’s Signature________________________________ Date ____________
Birthdate ________________________________________ Phone ( ) ______________________________

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90746_BR_CRA_2009:2  12/9/09  9:43 AM  Page 15

                                              CITY OF BIG RAPIDS
                    APPLICATION FOR EXTENSION

Name __________________________________________________________________________

Address (Number and Street) ________________________________________________________

City, State, Zip ____________________________________________________________________

Social Security # or
Federal I.D.# ____________________________________________________________________

Check type of return to be filed and attach Federal extension

                    ___________BR 1040 Individual                Attach Federal Form 4868

                    ___________BR 1120 Corporation               Attach Federal Form 7004

                    ___________BR 1065 Partnership               Attach Federal Form 7004

Taxable Year of _____________________ or Fiscal Year of______________ to ________________

Extension requested until_________________________________________, to file the Big Rapids
Income Tax Return (Not to exceed six months).

1.                  Your Tax Liability  $_____________________

2.                  Your Record of Credits
                    (a) Overpayments credited from prior year ______________
                    (b) Estimated tax payments for the year      ______________
                    (c) Withholding for the current year         ______________
                    (d) Tentative tax paid with application      ______________

                    TOTAL CREDITS                                $______________

                                              BALANCE   =                                $          -0-

An extension is not a request for additional time to pay tax due.
The filing of federal Forms 4868 and 7004, Application for Automatic Extension of Time to File U.S. Income Tax return, with the
Internal Revenue Service, does not grant an extension of time to file a city income tax return. An Application for an Extension
of Time to File a City Income Tax Return must be filed.

CITY INCOME TAX ORDINANCE - Sec. 64 Paragraph 2
Penalty  or  Interest  shall  not  be  assessed  if  the  return  is  filed  and  the  final  tax  paid  within  the  extended  time  and  all 
other  filing  and  payment  requirements  of  this  ordinance  are  satisfied,  and  the  estimated  tax  paid  equals  70%  or 
more  of  the  tax  shown  due  on  the  final  return,  or  70%  or  more  of  the  tax  shown  due  on  the  return  for  the  preceding
taxable year.

   Taxpayer/Authorized Signature                          Taxpayer/Authorized Signature

   Date

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Form BR 2106 Employee Business Expenses
City of Big Rapids Attach to Form BR 1040 2009
Your name Social Security number Occupation in which expenses were incurred

Part 1 Employee Business Expenses and Reimbursements

Column A Column B
STEP 1 Enter Your Expenses
Other Than Meals Meals

1. Vehicle Expense from Federal 2106.......................................................... 1. 00

2. Parking fees, tolls, and local transportation, including train, bus, etc. ...... 2. 00

3. Travel expense while away from home overnight, including lodging,
airplane, car rental, etc. Do Not include meals ............................................ 3. 00

4. Meals ........................................................................................................ 4. 00

5. Add lines 1 through 4 and enter the total expenses here........................ 5. 00

Note: If you were not reimbursed for any expenses in Step 1, skip line 6 and enter the amount from line 5 (both columns) on line 8.

STEP 2 Enter Amounts Your Employer Gave for Expenses Listed in Step 1

6. Enter amounts your employer gave you that were not reported to
you on your W-2. ...................................................................................... 6. 00 00

STEP 3 Figure Expenses To Deduct on Big Rapids Form 1040

7. Subtract line 6 from line 5. ........................................................................ 7. 00 00

8. Add the amounts on line 7 of both columns and enter the total here. Also enter the total on
Big Rapids Form 1040, line 3.................................................................................................................. 8. 00

CITY INCOME TAX ORDINANCE
Sec. 33. Ordinary, necessary, reasonable and unreimbursed expenses paid or incurred by an individual in
connection with the performance by him of services as an employee may be deducted from gross income in
determining income subject to the tax to the extent the expenses are applicable to income taxable under this
ordinance. The expenses are limited to the following:
(a) Expenses of travel, meals and lodging while away from home.
(b) Expenses as an outside salesman, away from his employer’s place of business.
(c) Expenses of transportation.
(d) Expenses under a reimbursement or other expense allowance arrangement with his
employer, where the reimbursement or allowance has been included in the total compensation reported.

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ADDRESS SERVICE REQUESTED
BIG RAPIDS, MI 49307
226 N. MICHIGAN AVENUE
BIG RAPIDS CITY INCOME TAX
RETURN TO:

2009 CITY OF BIG RAPIDS 2009

EMPLOYER’S WITHHOLDING TAX FORMS AND INSTRUCTIONS

Dear Employer,
All necessary forms for reporting and remitting City of Big Rapids Income Tax withholding for calendar year
2009 are enclosed.
Please review the pre-printed forms to see that the correct name, address and Federal Employer Identification
Number are listed. If an error is noted, file a Notice of Change or Discontinuance.

WHEN PREPARING W-2 FORMS, CLEARLY IDENTIFY THE LOCALITY IN BOX 20 OF THE
FORM AS BIG RAPIDS OR BR. THIS WILL HELP AVOID CONFUSION WITH OTHER MICHIGAN
CITIES WITH AN INCOME TAX.

WHO IS REQUIRED TO WITHHOLD?
Every employer who: QUESTIONS?
1. Has a location in the City of Big Rapids; or
2. Is doing business in the City of Big Rapids.
CALL

WITHHOLDING RATES: (231) 592-4012
Use 1% (.01) for:
1. Residents of the City of Big Rapids working anywhere,
2. Residents of the City of Big Rapids working outside of Big Rapids who are not subject to withholding for the city where
they work.
Use 1/2% (.005) for:
Nonresidents of the City of Big Rapids working in Big Rapids.

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CITY OF BIG RAPIDS
INCOME TAX DEPARTMENT

YEAR 2009 INCOME TAX WITHHOLDING FORMS AND INSTRUCTIONS

THIS BOOKLET CONTAINS THE FOLLOWING FORMS AND INSTRUCTIONS:

NOTICE OF CHANGE OR DISCONTINUANCE.

EMPLOYER’S MONTHLY OR QUARTERLY DEPOSIT OF INCOME TAX WITHHELD, FORM BR-941.

EMPLOYER’S ANNUAL RECONCILIATION OF INCOME TAX WITHHELD, FORM BRW-3. THIS FORM
MUST BE FILED ON OR BEFORE FEBRUARY 28, 2010.

INSTRUCTIONS FOR EMPLOYER’S MONTHLY OR QUARTERLY DEPOSIT OF INCOME TAX WITHHELD,
FORM BR-941.

A monthly deposit is required for the first and/or second month of a quarter when the amount withheld during the month
exceeds $100.00. If not complied with, the withholdings will be subject to interest and penalty.

EXEMPTIONS

Exemptions of $600.00 per year are allowed the employee for himself, his spouse, and each of his dependents.
Dependents and all deductions are those allowed by the Internal Revenue Service.

The withholding may be determined by a direct percentage. For residents 1%, for non-residents working inside
the city limits 1/2%. The following amounts may be used per exemptions.

Weekly $11.54
Bi-Weekly $23.08
Semi-Monthly $25.00
Monthly $50.00
Per Diem $1.65

FOR EXAMPLE:
Gross Weekly Pay $500.00
2 Exemptions $23.08
$476.92

Residents (1%) $4.77
Non-residents (1/2%) $2.38

PREPARING W-2 FORMS – IF BOX 20 OF THE W-2 FORM IS LEFT BLANK OR DOES NOT CLEARLY
IDENTIFY THE LOCALITY AS BIG RAPIDS OR BR, YOUR EMPLOYEES WILL EXPERIENCE A
DELAY IN THE PROCESSING OF THEIR RETURNS.

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CITY OF BIG RAPIDS
INCOME TAX DEPARTMENT

NOTICE OF CHANGE OR DISCONTINUANCE
ACCOUNT NUMBER (FEIN) CHANGES EFFECTIVE ON (Date)

CURRENT LEGAL NAME CHANGE LEGAL NAME TO

DBA CHANGE DBA TO

CURRENT LEGAL BUSINESS ADDRESS CHANGE LEGAL BUSINESS ADDRESS TO

MAILING ADDRESS CHANGE MAILING ADDRESS TO

Instructions: Place an “X” in all boxes that apply. Complete all information for that change.
Write any comments or explanations on back of form.

1. The Internal Revenue Service assigned us Federal Employer Identification Number: _________________________

2. Our Federal Employer Identification Number is wrong. The correct number is: ______________________________

3. We have incorporated. Our corporate name is: ______________________________________________________

4. Our new corporate Federal Employer Identification Number is: __________________________________________

5. Discontinue our withholding tax registration:

We no longer have any business activity in the City of Big Rapids.

We closed our business on: _________________________

We sold our entire business on: ______________________ We sold our business to:

______________________________________
______________________________________
______________________________________

We sold part of our business on:______________________ Their FEIN is: ___________________________

6. Address and phone number where we may be reached following discontinuance of business:

____________________ ____________________ _________________ _____ ____________ _______________
CONTACT PERSON STREET ADDRESS CITY STATE ZIP CODE PHONE

7. Change in ownership. (Please explain on back)

8. Effective _____________________, we changed our fiscal year ending from ______________ to ______________
MONTH/YEAR MONTH MONTH

9. Other changes. (Please explain on back)

SIGNATURE OF PREPARER PRINTED NAME OF PREPARER DATE PREPARED PREPARER’S PHONE NUMBER
( ) -

MAIL THIS NOTICE AND ANY CORRESPONDENCE TO: BIG RAPIDS INCOME TAX DEPARTMENT, 226 N. MICHIGAN AVENUE, BIG RAPIDS, MI 49307

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BRW-3 2009 CITY OF BIG RAPIDS BRW-3 2009

EMPLOYER’S ANNUAL RECONCILIATION OF INCOME TAX WITHHELD

1. EMPLOYER NAME & ADDRESS 2. FEDERAL EMPLOYER IDENTIFICATION NUMBER

DUE ON OR BEFORE
FEBRUARY 28, 2010

SUMMARY OF WITHHOLDING TAX PAID
MONTH/QUARTER TAX WITHHELD WITHHOLDING TAX PAID
January
February
March
FIRST QUARTER TOTAL
April
May
June
SECOND QUARTER TOTAL
July
August
September
THIRD QUARTER TOTAL
October
November
December
FOURTH QUARTER TOTAL
TOTAL WITHHOLDING TAX PAID 3.
TOTAL BIG RAPIDS WAGES FROM BOX 18 OF YOUR 2009 W-2(S) 4.
NUMBER OF W-2 FORMS ATTACHED 5.
TOTAL TAX WITHHELD PER W-2(S) 6.
BALANCE DUE 7.
REFUND 8.
9. SIGNATURE 10. NAME AND TITLE (Please Print) PHONE # 11. DATE

INSTRUCTIONS FOR EMPLOYER’S ANNUAL RECONCILIATION OF INCOME TAX WITHHELD
• Check identification information in Box 1 and Box 2. If incorrect, make corrections and file Notice of Change or Discontinuance.
• Enter tax withheld and tax payment information in the Summary of Withholding Tax Paid section.
• Enter the total withholding tax paid in Box 3.
• Enter the number of W-2 forms attached in Box 5.
• Enter the amount of tax withheld per the W-2 forms attached in Box 6. Attach an adding machine tape totaling the W-2 forms and include copies
of W-2 forms.
• It is being requested that you attach a copy of your 3 1/2-inch diskette or CD if available of your W-2’s for 2009. (See last two pages of this
booklet for filing diskette from Innovative Software Company. Make sure you include box 18, 19, and 20 of W-2’s on the diskette).
• If the withholding tax paid (Box 3) is less than the tax withheld per the W-2 forms (Box 6), enter the balance due in Box 7. The balance due must be
paid in full with this BRW-3 form. Make remittance payable to: BIG RAPIDS CITY TREASURER.
• If the withholding tax paid (Box 3) is greater than the tax withheld per the W-2 forms (Box 6), enter the refund in Box 8.
• If the withholding tax paid (Box 3) equals the tax withheld per the W-2 forms (Box 6) enter a zero (0) in Boxes 7 and 8.
• Sign the return in Box 9; Print your name, title, and phone number in Box 10; and enter the date signed in Box 11.
• Attach the required copies of the W-2 forms and payment for any balance due to the completed BRW-3 form and mail to:
BIG RAPIDS TREASURER’S OFFICE, 226 N. MICHIGAN AVENUE, BIG RAPIDS, MI 49307.

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CITY OF BIG RAPIDS
INCOME TAX DEPARTMENT

INSTRUCTIONS FOR FORM BR-941, EMPLOYER’S MONTHLY DEPOSIT OF INCOME TAX WITHHELD,
AND FORM BR-941, EMPLOYER’S QUARTERLY RETURN OF INCOME TAX WITHHELD.

A. MONTHLY DEPOSITS AND QUARTERLY RETURNS
1. Monthly deposits of Big Rapids income tax withheld are required for each month in which the amount withheld exceeds
$100.00. Monthly deposits are made using Form BR-941. Remittance in full payable to the Big Rapids City Treasurer is
required. Monthly deposits are due on the last day of the month following the month withheld. Example: The monthly deposit,
Form BR-941, for May is due June 30.
2. Quarterly returns of Big Rapids income tax withheld are filed using Form BR-941. Remittance payable to Big Rapids City
Treasurer is required. Quarterly returns and payments are due on the last day of the month following the end of the quarter. The
quarterly return, Form BR-941, for the first quarter is due April 30.
3. Mail monthly deposits and Form BR-941, to the Big Rapids Treasurer’s Office, 226 N. Michigan Avenue, Big Rapids, MI 49307.
4. A monthly deposit is not required if less than $100 is withheld during a month.
5. A quarterly return, Form BR-941, is required even though no tax was withheld during a quarter. Under such circumstances, a
quarterly return, form BR-941, must be filed showing zero tax withheld.
6. If the payment of wages has been temporarily discontinued for any reason, such as the seasonal nature of the business, the
employer must continue to file returns.

B. INITIAL RETURNS
1. Registration via phone accepted at (231) 592-4012. Withholding forms and an employer’s registration packet will be mailed
immediately.
2. If you cannot wait for forms to timely file your first return, include a letter with your withholding tax payment providing the fol-
lowing information: Name of Business Owner(s), Type of Ownership, Employer Identification Number (EIN), d.b.a., address,
mailing address and period covered.
3. If a business is sold or transferred at any point during a reporting period, both the old and new employer must file returns for the
period. Neither employer should report tax withheld by the other, both employers should use their own EIN numbers. Also see
instructions for Final Returns.

C. FINAL RETURNS – NOTICE OF CHANGE OR DISCONTINUANCE
1. If no wages are to be paid in the future, complete and file a Notice of Change or Discontinuance.
2. If the business has been sold or transferred, provide the name of the new owner(s), the date transferred and their EIN. Also, pro-
vide the name, address and telephone number of the person who will have custody of the books and records of the discontinued
business.
3. When discontinuing a business, the Employer’s Annual Reconciliation of Income Tax Withheld, Form BRW-3, and a W-2 form
for each employee must be filed. These forms are due by the end of the month following the end of the quarter of discontinuance.
4. It is being requested that you attach a copy of your 3 1/2-inch diskette or CD if available of your W-2’s for 2009. (See last two
pages of this booklet for filing diskette). Make sure you include box 18, 19, and 20 of W-2’s on the diskette.

D. ALL EMPLOYERS
1. Pre-printed forms should be used in filing returns. If you do not have forms for filing, contact the Income Tax Department at
(231) 592-4012 so forms can be mailed to you prior to the due date, or download off our website: www.ci.big-rapids.mi.us
2. Verify the name, address and EIN on the monthly deposit and quarterly return form BR-941. If an error is noted, the necessary
corrections should be made on the form, and a Notice of Change or Discontinuance should be completed and filed.
3. Form BR-941 provides a space for adjustments to correct mistakes made on prior returns from the current calendar year. When
an adjustment is reported it must be accompanied by a statement explaining the adjustment. DO NOT TAKE CREDIT FOR A
PRIOR YEAR’S OVERPAYMENT!
4. Calculate and remit penalty and interest on all delinquent tax payments and delinquent returns.

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BR-941                                        BIG RAPIDS INCOME TAX DEPARTMENT                                                                     BR-941
                                        EMPLOYER’S MONTHLY DEPOSIT OF INCOME TAX WITHHELD

                       2009  941  1M

DO NOT           1. IDENTIFICATION NUMBER        2. DEPOSIT PERIOD                                3. DUE ON OR BEFORE    4. WITHHOLDING TAX DEPOSIT
WRITE IN                                         JANUARY 2009                                         2/28/2009
SPACE BELOW
                 TAXPAYER                                                                                                MONTHLY DEPOSIT OF INCOME TAX IS
                                                                                                                         REQUIRED IF TAX WITHHELD IN FIRST
                                                                                                                         OR SECOND MONTH OF A QUARTER
                                                                                                                         EXCEEDS $100.

                                                                                                                         MAKE REMITTANCE PAYABLE TO:
___________________________________________      __________________________________________    _________________         BIG RAPIDS CITY TREASURER
SIGNATURE                                  TITLE                                                  DATE
                                                                                                                         MAIL THIS FORM AND PAYMENT TO:
___________________________________________      __________________________________________                              BIG RAPIDS TREASURER’S OFFICE
PRINTED NAME OF SIGNER                     TELEPHONE NUMBER                                                              226 N. MICHIGAN AVENUE
                                                                                                                         BIG RAPIDS, MI 49307

BR-941                                        BIG RAPIDS INCOME TAX DEPARTMENT                                                                     BR-941
                                        EMPLOYER’S MONTHLY DEPOSIT OF INCOME TAX WITHHELD

                       2009  941  2M

DO NOT           1. IDENTIFICATION NUMBER        2. DEPOSIT PERIOD                                3. DUE ON OR BEFORE    4. WITHHOLDING TAX DEPOSIT
WRITE IN                                         FEBRUARY 2009                                        3/31/2009
SPACE BELOW
                 TAXPAYER                                                                                                MONTHLY DEPOSIT OF INCOME TAX IS
                                                                                                                         REQUIRED IF TAX WITHHELD IN FIRST
                                                                                                                         OR SECOND MONTH OF A QUARTER
                                                                                                                         EXCEEDS $100.

                                                                                                                         MAKE REMITTANCE PAYABLE TO:
___________________________________________      __________________________________________    _________________         BIG RAPIDS CITY TREASURER
SIGNATURE                                  TITLE                                                  DATE
                                                                                                                         MAIL THIS FORM AND PAYMENT TO:
___________________________________________      __________________________________________                              BIG RAPIDS TREASURER’S OFFICE
PRINTED NAME OF SIGNER                     TELEPHONE NUMBER                                                              226 N. MICHIGAN AVENUE
                                                                                                                         BIG RAPIDS, MI 49307

BR-941                                        BIG RAPIDS INCOME TAX DEPARTMENT                                                                     BR-941
                                        EMPLOYER’S MONTHLY DEPOSIT OF INCOME TAX WITHHELD

                       2009  941  1Q

DO NOT           1. IDENTIFICATION NUMBER        2. DEPOSIT PERIOD                                3. DUE ON OR BEFORE
SPACE BELOW                                      1 QUARTER 2009
WRITE IN                                         STMARCH OR                                           4/30/2009          TAX REMITTED
                 TAXPAYER
                                                                                                                 January

                                                                                                                 February

                                                                                                                 March

_______________________________________    _______________________________________    ___________________ Adjustments
SIGNATURE                               TITLE                                                 DATE
                                                                                                                 TOTAL
_______________________________________
PRINTED NAME OF SIGNER                                                                                                   PAY TO: BIG RAPIDS CITY TREASURER
                                                                                                                         MAIL TO: BIG RAPIDS TREASURER’S OFFICE
_______________________________________   If final return, check here and complete Notice                            226 N. MICHIGAN AVENUE
TELEPHONE NUMBER                              of Change or Discontinuance in return booklet.                             BIG RAPIDS, MI 49307

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BR-941                                        BIG RAPIDS INCOME TAX DEPARTMENT                                                                      BR-941
                                        EMPLOYER’S MONTHLY DEPOSIT OF INCOME TAX WITHHELD

                       2009  941  4M

DO NOT           1. IDENTIFICATION NUMBER        2. DEPOSIT PERIOD                                3. DUE ON OR BEFORE     4. WITHHOLDING TAX DEPOSIT
WRITE IN                                         APRIL 2009                                           5/31/2009
SPACE BELOW
                 TAXPAYER                                                                                                 MONTHLY DEPOSIT OF INCOME TAX IS
                                                                                                                          REQUIRED IF TAX WITHHELD IN FIRST
                                                                                                                          OR SECOND MONTH OF A QUARTER
                                                                                                                          EXCEEDS $100.

                                                                                                                          MAKE REMITTANCE PAYABLE TO:
___________________________________________      __________________________________________    _________________          BIG RAPIDS CITY TREASURER
SIGNATURE                                  TITLE                                                  DATE
                                                                                                                          MAIL THIS FORM AND PAYMENT TO:
___________________________________________      __________________________________________                               BIG RAPIDS TREASURER’S OFFICE
PRINTED NAME OF SIGNER                     TELEPHONE NUMBER                                                               226 N. MICHIGAN AVENUE
                                                                                                                          BIG RAPIDS, MI 49307

BR-941                                        BIG RAPIDS INCOME TAX DEPARTMENT                                                                      BR-941
                                        EMPLOYER’S MONTHLY DEPOSIT OF INCOME TAX WITHHELD

                       2009  941  5M

DO NOT           1. IDENTIFICATION NUMBER        2. DEPOSIT PERIOD                                3. DUE ON OR BEFORE     4. WITHHOLDING TAX DEPOSIT
WRITE IN                                         MAY 2009                                             6/30/2009
SPACE BELOW
                 TAXPAYER                                                                                                 MONTHLY DEPOSIT OF INCOME TAX IS
                                                                                                                          REQUIRED IF TAX WITHHELD IN FIRST
                                                                                                                          OR SECOND MONTH OF A QUARTER
                                                                                                                          EXCEEDS $100.

                                                                                                                          MAKE REMITTANCE PAYABLE TO:
___________________________________________      __________________________________________    _________________          BIG RAPIDS CITY TREASURER
SIGNATURE                                  TITLE                                                  DATE
                                                                                                                          MAIL THIS FORM AND PAYMENT TO:
___________________________________________      __________________________________________                               BIG RAPIDS TREASURER’S OFFICE
PRINTED NAME OF SIGNER                     TELEPHONE NUMBER                                                               226 N. MICHIGAN AVENUE
                                                                                                                          BIG RAPIDS, MI 49307

BR-941                                        BIG RAPIDS INCOME TAX DEPARTMENT                                                                      BR-941
                                        EMPLOYER’S MONTHLY DEPOSIT OF INCOME TAX WITHHELD

                       2009  941  2Q

DO NOT           1. IDENTIFICATION NUMBER        2. DEPOSIT PERIOD                                3. DUE ON OR BEFORE
SPACE BELOW                                      2
WRITE IN                                         NDQUARTERJUNE OR2009                                 7/31/2009           TAX REMITTED
                 TAXPAYER
                                                                                                                     April

                                                                                                                      May

                                                                                                                     June

_______________________________________    _______________________________________    ___________________ Adjustments
SIGNATURE                               TITLE                                                 DATE
                                                                                                                 TOTAL
_______________________________________
PRINTED NAME OF SIGNER                                                                                                    PAY TO: BIG RAPIDS CITY TREASURER
                                                                                                                          MAIL TO: BIG RAPIDS TREASURER’S OFFICE
_______________________________________   If final return, check here and complete Notice                             226 N. MICHIGAN AVENUE
TELEPHONE NUMBER                              of Change or Discontinuance in return booklet.                              BIG RAPIDS, MI 49307

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BR-941                                        BIG RAPIDS INCOME TAX DEPARTMENT                                                                      BR-941
                                        EMPLOYER’S MONTHLY DEPOSIT OF INCOME TAX WITHHELD

                       2009  941  7M

DO NOT           1. IDENTIFICATION NUMBER        2. DEPOSIT PERIOD                                3. DUE ON OR BEFORE     4. WITHHOLDING TAX DEPOSIT
WRITE IN                                         JULY 2009                                            8/31/2009
SPACE BELOW
                 TAXPAYER                                                                                                 MONTHLY DEPOSIT OF INCOME TAX IS
                                                                                                                          REQUIRED IF TAX WITHHELD IN FIRST
                                                                                                                          OR SECOND MONTH OF A QUARTER
                                                                                                                          EXCEEDS $100.

                                                                                                                          MAKE REMITTANCE PAYABLE TO:
___________________________________________      __________________________________________    _________________          BIG RAPIDS CITY TREASURER
SIGNATURE                                  TITLE                                                  DATE
                                                                                                                          MAIL THIS FORM AND PAYMENT TO:
___________________________________________      __________________________________________                               BIG RAPIDS TREASURER’S OFFICE
PRINTED NAME OF SIGNER                     TELEPHONE NUMBER                                                               226 N. MICHIGAN AVENUE
                                                                                                                          BIG RAPIDS, MI 49307

BR-941                                        BIG RAPIDS INCOME TAX DEPARTMENT                                                                      BR-941
                                        EMPLOYER’S MONTHLY DEPOSIT OF INCOME TAX WITHHELD

                       2009  941  8M

DO NOT           1. IDENTIFICATION NUMBER        2. DEPOSIT PERIOD                                3. DUE ON OR BEFORE     4. WITHHOLDING TAX DEPOSIT
WRITE IN                                         AUGUST 2009                                          9/30/2009
SPACE BELOW
                 TAXPAYER                                                                                                 MONTHLY DEPOSIT OF INCOME TAX IS
                                                                                                                          REQUIRED IF TAX WITHHELD IN FIRST
                                                                                                                          OR SECOND MONTH OF A QUARTER
                                                                                                                          EXCEEDS $100.

                                                                                                                          MAKE REMITTANCE PAYABLE TO:
___________________________________________      __________________________________________    _________________          BIG RAPIDS CITY TREASURER
SIGNATURE                                  TITLE                                                  DATE
                                                                                                                          MAIL THIS FORM AND PAYMENT TO:
___________________________________________      __________________________________________                               BIG RAPIDS TREASURER’S OFFICE
PRINTED NAME OF SIGNER                     TELEPHONE NUMBER                                                               226 N. MICHIGAN AVENUE
                                                                                                                          BIG RAPIDS, MI 49307

BR-941                                        BIG RAPIDS INCOME TAX DEPARTMENT                                                                      BR-941
                                        EMPLOYER’S MONTHLY DEPOSIT OF INCOME TAX WITHHELD

                       2009  941  3Q

DO NOT           1. IDENTIFICATION NUMBER        2. DEPOSIT PERIOD                                3. DUE ON OR BEFORE
SPACE BELOW                                      3
WRITE IN                                         SEPTEMBERRDQUARTER 2009OR                            10/31/2009          TAX REMITTED
                 TAXPAYER
                                                                                                                      July

                                                                                                                 August

                                                                                                          September

_______________________________________    _______________________________________    ___________________ Adjustments
SIGNATURE                               TITLE                                                 DATE
                                                                                                                 TOTAL
_______________________________________
PRINTED NAME OF SIGNER                                                                                                    PAY TO: BIG RAPIDS CITY TREASURER
                                                                                                                          MAIL TO: BIG RAPIDS TREASURER’S OFFICE
_______________________________________   If final return, check here and complete Notice                             226 N. MICHIGAN AVENUE
TELEPHONE NUMBER                              of Change or Discontinuance in return booklet.                              BIG RAPIDS, MI 49307

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BR-941                                        BIG RAPIDS INCOME TAX DEPARTMENT                                                                    BR-941
                                        EMPLOYER’S MONTHLY DEPOSIT OF INCOME TAX WITHHELD

                       2009  941  10M

DO NOT           1. IDENTIFICATION NUMBER        2. DEPOSIT PERIOD                                3. DUE ON OR BEFORE   4. WITHHOLDING TAX DEPOSIT
WRITE IN                                         OCTOBER 2009                                         11/30/2009
SPACE BELOW
                 TAXPAYER                                                                                               MONTHLY DEPOSIT OF INCOME TAX IS
                                                                                                                        REQUIRED IF TAX WITHHELD IN FIRST
                                                                                                                        OR SECOND MONTH OF A QUARTER
                                                                                                                        EXCEEDS $100.

                                                                                                                        MAKE REMITTANCE PAYABLE TO:
___________________________________________      __________________________________________    _________________        BIG RAPIDS CITY TREASURER
SIGNATURE                                  TITLE                                                  DATE
                                                                                                                        MAIL THIS FORM AND PAYMENT TO:
___________________________________________      __________________________________________                             BIG RAPIDS TREASURER’S OFFICE
PRINTED NAME OF SIGNER                     TELEPHONE NUMBER                                                             226 N. MICHIGAN AVENUE
                                                                                                                        BIG RAPIDS, MI 49307

BR-941                                        BIG RAPIDS INCOME TAX DEPARTMENT                                                                    BR-941
                                        EMPLOYER’S MONTHLY DEPOSIT OF INCOME TAX WITHHELD

                       2009  941  11M

DO NOT           1. IDENTIFICATION NUMBER        2. DEPOSIT PERIOD                                3. DUE ON OR BEFORE   4. WITHHOLDING TAX DEPOSIT
WRITE IN                                         NOVEMBER 2009                                        12/31/2009
SPACE BELOW
                 TAXPAYER                                                                                               MONTHLY DEPOSIT OF INCOME TAX IS
                                                                                                                        REQUIRED IF TAX WITHHELD IN FIRST
                                                                                                                        OR SECOND MONTH OF A QUARTER
                                                                                                                        EXCEEDS $100.

                                                                                                                        MAKE REMITTANCE PAYABLE TO:
___________________________________________      __________________________________________    _________________        BIG RAPIDS CITY TREASURER
SIGNATURE                                  TITLE                                                  DATE
                                                                                                                        MAIL THIS FORM AND PAYMENT TO:
___________________________________________      __________________________________________                             BIG RAPIDS TREASURER’S OFFICE
PRINTED NAME OF SIGNER                     TELEPHONE NUMBER                                                             226 N. MICHIGAN AVENUE
                                                                                                                        BIG RAPIDS, MI 49307

BR-941                                        BIG RAPIDS INCOME TAX DEPARTMENT                                                                    BR-941
                                        EMPLOYER’S MONTHLY DEPOSIT OF INCOME TAX WITHHELD

                       2009  941  4Q

DO NOT           1. IDENTIFICATION NUMBER        2. DEPOSIT PERIOD                                3. DUE ON OR BEFORE
SPACE BELOW                                      4 QUARTER 2009
WRITE IN                                         DECEMBERTH        OR                                 1/31/2010         TAX REMITTED
                 TAXPAYER
                                                                                                                 October

                                                                                                          November

                                                                                                          December

_______________________________________    _______________________________________    ___________________ Adjustments
SIGNATURE                               TITLE                                                 DATE
                                                                                                                 TOTAL
_______________________________________
PRINTED NAME OF SIGNER                                                                                                  PAY TO: BIG RAPIDS CITY TREASURER
                                                                                                                        MAIL TO: BIG RAPIDS TREASURER’S OFFICE
_______________________________________   If final return, check here and complete Notice                           226 N. MICHIGAN AVENUE
TELEPHONE NUMBER                              of Change or Discontinuance in return booklet.                            BIG RAPIDS, MI 49307

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W3 FORMATS

There are four acceptable formats for electronic filing.

Federal Filing Format – MMREF
This format is required starting with the 2002 tax year.

Information about the Federal MMREF format is available on the Social Security Adminstration website at
www.ssa.gov/employer

State Formats – 1A and A
The Federal site states that the new format is accepted by the State of Michigan as well. However, the Sales, Use
and Withholding Taxes Annual Return Instructions still show the old formats. They will continue to be supported.

City Tax Proprietary Format (CTP)
This is a sample format for a single employer. It may be created using Microsoft Excel. It is a comma Delimited
format. Details are on a later page.

The following table lists critical fields, with the location in that format.

MMREF 1A A CTP
Local Entity Record RS 2S S CTW
Code Start Position 5 82 219 12
Length 555--
Local Record RS 2S S CTW
Withholding Start Position 320 96 233 13
Length 12 79--
Local Record RS 2S S CTW
Taxable Start Position 309 87 224 11
Length 12 99--

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Local Entity Codes
Use the following entity codes for Michigan cities:
Albion ALB Jackson JAC
Battle Creek BC Lansing LAN
Big Rapids BR Lapeer LAP
Detroit DET Muskegon MKG
Flint FL Muskegon Heights MH
Grand Rapids GR Pontiac PNT
Grayling GRA Port Huron PH
Hamtramck HAM Portland POR
Highland Park HP Saginaw SAG
Hudson HUD Springfield SPR
Ionia ION Walker WALK

City Tax Proprietary
This is a comma-delimited format. That means that each field is separated by a comma. See below for instruciton on
creating this file from Microsoft Excel. All text must be in upper case. If leading zeros on Tax Id’s or Zipcodes do not show,
this is all right.

First Line: Employer
A. CTE text exactly as shown
B. Employer FEIN or TaxID 9 digits no spaces or punctuation
C. TaxYear 4 digits
D. Employer Name
E. Corporate C if a corporation, blank otherwise
F. Employer street address No commas
G. Employer City
H. Employer State 2 characters
I. Employer Zipcode 5 digits (or 6 characters if foreign country)
J. Employer Plus4 4 digits

Remaining Lines: One per Employee
A. CTW text exactly as shown
B. Employee SSN 9 digits no spaces or punctuation
C. Employee Last Name
D. Employee First Name
E. Employee Middle Name
F. Employee Street Address No commas
G. Employee City
H. Employee State 2 characters
I. Employee Zipcode 5 digits (or 6 characters if foreign country)
J. Employee Plus4 4 digits
K. Wages Entered as normal number with decimal point
L. Local Entity Code See table above
M. Local Withholding Entered as normal number with decimal point

How to Create CTP format using Microsoft Excel
1. Open a new spreadsheet.
2. On the first line, enter the Employer data as specified above, entering one value per column. The letter shown at the start
of each line must match the letter at the top of the column in Excel. Skip the column if blank. Insure all entries are upper
case. To start, enter ‘CTE’ in the first column.
3. For each employee, enter another line, entering CTE in the first column (A) and entering one field per column.
4. Click on the Save button (or select Save from the File menu). At the bottom is a drop down box for Save as type. Click
on this drop-down and select
‘CVS (Comma delimited)(*.csv)’
Then enter a file name and click save.
5. Copy this file to a diskette or compact disc and send to the Income Tax office.

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90746_BR_CRA_2009:2 12/9/09 9:43 AM Page 19

INSTRUCTIONS FOR CITY OF BIG RAPIDS DECLARATION OF ESTIMATED INCOME TAX

1. WHO MUST MAKE A DECLARATION

A. Individuals and Unincorporated Businesses must file a declaration and make estimated
payments if annual liability is over $100.00.
B. Corporations must file a declaration and make estimated payments if annual liability is
over $250.00.
C. Partnerships must file a declaration and make estimated payments only if the
partnership is the only income that is subject to Big Rapids Tax and they do not wish to
carry the income over to an individual return.

2. WHEN AND WHERE TO FILE DECLARATION AND PAY TAX

A. Calendar Year - The declaration must be filed on or before April 30th of the new tax year.
B. Fiscal Year - The declaration must be filed four months after the beginning of the fiscal
year.
C. Filing - Treasurer’s Office
226 North Michigan Avenue
Big Rapids, MI 49307
D. Payment - Must be paid in full with the declaration or in four equal installments on or
before April 30, June 30, September 30, January 30, or on or before the fourth, sixth,
ninth and thirteenth month after the beginning of the fiscal year.

3. PENALTIES AND INTEREST

If the total amount of tax withheld or paid by declaration is less than seventy percent (70%) of
the final tax due or less than 70% of the previous tax year, interest will be charged at the rate
of .0001164 per day and penalty will be charged at the rate of 1% per month, not exceeding
25% of the tax due or a combined minimum of $2.00.

THE FILING OF A DECLARATION OF ESTIMATED TAX DOES NOT EXCUSE THE TAXPAYER
FROM FILING AN ANNUAL RETURN EVEN THOUGH THERE IS NO CHANGE IN THE DECLARED
TAX LIABILITY.

1. Taxable Income Expected in 2010 .......................................................... $ 00
PAYMENT
RECORD 2. Exemptions ($600 for Each Exemption) ................................................ $ 00
DATE TAX PAID CHECK NO.
3. Estimated Big Rapids Taxable Income (Line 1 Less Line 2) .................. $ 00
1ST
4. Estimated Big Rapids Income
2ND (Non-resident individuals enter 1/2% of Line 3; all other taxpayers enter 1% of Line 3) .. $ 00
3RD 5. Big Rapids Income Tax to be withheld or Other Credit Expected in 2010 .... $ 00
4TH 6. Estimated Tax: (Line 4 Less Line 5)........................................................ $ 00
TOTAL

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       BR 1120ES                                      Income Tax Division
                     or                                 CITY OF BIG RAPIDS                                 VOUCHER 4
                     BR 1040ES              Estimated Tax Declaration - Voucher                          4th Quarter
       CITY OF BIG RAPIDS                                         For the Year 2010               (Calendar Year - Due Jan. 30, 2011)
                     To be used for making declaration and payment
Employee Federal I.D. # or Social Security #
Name                                                                                Estimated Tax          $__________________
Address
                                                                                    Amount of this payment $__________________
City, State, Zip Code

       Return this voucher with check or money order payable to:                    __________________________________________
                        “City of Big Rapids” and mail to
       Treasurer’s Office, 226 N. Michigan, Big Rapids, Michigan 49307              SIGN HERE

       BR 1120ES                                      Income Tax Division
                     or                                 CITY OF BIG RAPIDS                                 VOUCHER 3
                     BR 1040ES              Estimated Tax Declaration - Voucher                          3rd Quarter
       CITY OF BIG RAPIDS                                         For the Year 2010               (Calendar Year - Due Sept. 30, 2010)
                     To be used for making declaration and payment
Employee Federal I.D. # or Social Security #
Name                                                                                Estimated Tax          $__________________
Address
                                                                                    Amount of this payment $__________________
City, State, Zip Code

       Return this voucher with check or money order payable to:                    __________________________________________
                        “City of Big Rapids” and mail to
       Treasurer’s Office, 226 N. Michigan, Big Rapids, Michigan 49307              SIGN HERE

       BR 1120ES                                      Income Tax Division
                     or                                 CITY OF BIG RAPIDS                                 VOUCHER 2
                     BR 1040ES              Estimated Tax Declaration - Voucher                          2nd Quarter
       CITY OF BIG RAPIDS                                         For the Year 2010               (Calendar Year - Due June 30, 2010)
                     To be used for making declaration and payment
Employee Federal I.D. # or Social Security #
Name                                                                                Estimated Tax          $__________________
Address
                                                                                    Amount of this payment $__________________
City, State, Zip Code

       Return this voucher with check or money order payable to:                    __________________________________________
                        “City of Big Rapids” and mail to
       Treasurer’s Office, 226 N. Michigan, Big Rapids, Michigan 49307              SIGN HERE

       BR 1120ES                                      Income Tax Division
                     or                                 CITY OF BIG RAPIDS                                 VOUCHER 1
                     BR 1040ES              Estimated Tax Declaration - Voucher                          1st Quarter
       CITY OF BIG RAPIDS                                         For the Year 2010               (Calendar Year - Due April 30, 2010)
                     To be used for making declaration and payment
Employee Federal I.D. # or Social Security #
Name                                                                                Estimated Tax          $__________________
Address
                                                                                    Amount of this payment $__________________
City, State, Zip Code

       Return this voucher with check or money order payable to:                    __________________________________________
                        “City of Big Rapids” and mail to
       Treasurer’s Office, 226 N. Michigan, Big Rapids, Michigan 49307              SIGN HERE

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90746_BR_CRA_2009:2 12/9/09 9:43 AM Page 1

                            CITY OF BIG RAPIDS

                                          2009

                                    REPRODUCIBLE

                    CITY INCOME TAX FORMS

HERE ARE YOUR REPRODUCIBLE FORMS

Reproducible masters of the City of Big Rapids

Income Tax Forms enable tax practitioners to

produce copies of forms.

The City will accept copies for filing.

These master forms are suitable for reproduction

on an offset press or photo copier. It is often more

economical for preparers who need many forms to

take these to a local printing company rather than

photocopy.

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90746_BR_CRA_2009:2 12/9/09 9:43 AM Page 2

                                          TAX YEAR 2009

1. City administration will be using two different addresses for the 2009 tax year.

   Mail with payment to:                  Mail for refund to:
   City of Big Rapids                     City of Big Rapids
   Treasurer’s Office                     Income Tax Office
   226 North Michigan Avenue              226 North Michigan Avenue
   Big Rapids, MI 49307                   Big Rapids, MI 49307

2. The voluntary contribution line on your return is for donations for the Big Rapids
   Community Pool and/or the Big Rapids Community Library. The contributions will not be used
   for any other recreational programs.

3. If you are filing as a non-resident, you are being asked to report the township in
   which you reside.

4. Location -       The City’s Income Tax Office is located on the South side entrance of City
   Hall. Returns with payment should be submitted to the Treasurer’s Office.

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                                          General Information

This booklet contains a return and the                    MARRIED PERSON JOINT OR SEPARATE
instructions for filing your 2009 Individual City of Big  RETURNS
Rapids Income Tax Return. Read all of the                 Married persons may file either a joint or separate
instructions carefully before completing your return.     return. Residents filing jointly must include all income
Since some of the information on your City return may     of both spouses. Non-residents filing jointly must
be based on your Federal Form, a copy of the front of     include Big Rapids earned income of both spouses. In
your Federal Form and any applicable Federal              the case of a non-resident, where only one spouse
Schedules must be attached.                               has Big Rapids earned income, you can claim your
                                                          spouse as an exemption, however, both must sign
WHO MUST FILE A TAX RETURN                                the return. If you file jointly, both names must be listed
Every resident and non-resident who had a gross           in the heading and both must sign the return. If you file
income of $600.00 or more from sources listed under       separately, dependents can only be claimed by the
“What is Taxable Income” must complete and file a         spouse who would be entitled to claim such depend-
return, even though you do not file a Federal return. If  ents under Federal Internal Revenue Code.
you wish to claim a refund because the tax withheld or
paid is more than the tax due, you must file a return. If DECEASED TAXPAYERS
you filed a Declaration of Estimated Tax, you must file   A return for a taxpayer who died during the taxable
a return even though there is no change in tax liability. year should be filed on the same basis as they would
                                                          have filed if they had lived. If a refund is due on the
RESIDENCY                                                 return and the check is to be made payable to a per-
A Big Rapids RESIDENT is a person domiciled within        son(s) other than the surviving spouse, a letter of
the Big Rapids City limits. “Domicile” means a place      explanation must be attached.
where a person has a true, fixed, and permanent
home. A NON-RESIDENT is a person domiciled out-           DUE DATE
side the City Limits.                                     Your return is due on or before April 30, 2010. The due
                                                          date of Big Rapids annual returns may be extended for
FERRIS STATE UNIVERSITY STUDENTS                          a period not to exceed six months. When a city exten-
Married students, living in Big Rapids, where one or      sion is granted, tentative tax must be paid by April 30,
both are attending Ferris, are considered residents,      2010. Applications for extensions are available from
unless you are maintaining a permanent residence          the City Income Tax Department.
elsewhere.
                                                          Applying for a federal extension does not satisfy the
Single students, living in Big Rapids and attending       requirement for filing a city extension; an application
Ferris are considered residents unless you are main-      for a Big Rapids extension must still be made and any
taining a permanent residence elsewhere (including        tentative tax due must be paid.
parents home) or are registered to vote elsewhere.
                                                          DECLARATION OF ESTIMATED TAX
CHANGE OF RESIDENT STATUS                                 If you expect that your City of Big Rapids tax will
Any person whose residence changed either from a          exceed amounts after withheld from your pay to be
resident to a non-resident or a non-resident to a resi-   $100.00 or more, you must file a Declaration of
dent during the taxable year and had Big Rapids           Estimated Tax by April 30, and pay at least one fourth
earned income both as a resident AND a non-resident       of the estimated tax with your declaration. The remain-
will file using the Part Year Resident Form which may     ing balance will be due in three equal installments to be
be obtained through the Treasurer’s Office or Income      paid on June 30, September 30, and on January 30.
Tax Office.

- 30 -

WHAT IS TAXABLE INCOME
RESIDENTS tangible personal property located in Big Rapids.
6. All Corporations within the City of Big Rapids,
A resident is subject to tax on all i tems included in total
including Subchapter S, taxable under the City Income
Federal income (Subject to certain exclusions as listed in
Tax Ordinance must file as conventional corporations
“What is Non-Taxable Income.”).
with the City of Big Rapids. Do not include on this return
Taxable income would include: any profit, losses or other deductions from a Subchapter S
1. Salaries, bonuses, wages, commissions, fees, Corporation
vacation pay, profit sharing plan income, severance pay, 7. Pre mature wit hdrawals of p roceeds fro m insu rance,
tips, sabbatical pay, sick pay, and other compensation pensions, a nnuities and retire ment benefits, incl uding
regardless of where earned. distributions that are rec eived from qualified trusts upon
2. Fair ma rket value of merchandise or service s termination of employment and receive treatment
received as compensation. as gains under the Internal Revenue Service.
3. Net profit or loss from the operati on of a busin ess or
profession or other activity regardless of where earned. 4. WHAT IS NON-TAXABLE INCOME
Income from a partnership, interest from an estate or trust, RESIDENTS AND NON-RESIDENTS
bank accounts, credit unions, saving and loan The following types of income are non -taxable both to a
associations and other income regardl ess of where resident and a non-resident.
earned. 1. Gifts, inheritances, bequests and distributions of
5. Rental income, capital gains, and dividends. principal from estates and trusts.
6. Winnings from the State Lottery and all gamblings. 7. 2. Proceeds from insurance, pensions, annuities and
Alimony received. retirement benefits (including SOCIAL SECURITY) even
8. All Corporations within the City of Big Rapids, if taxable under the Federal Internal Revenue Codes.
including Subchapter S, taxable under the City Income Premature withdrawals are taxable both to resident
Tax Ordinance must file as conventional corporations and non-resident.
with the City of Big Rapids. Do not include on this return 3. Amounts received for personal injuries, sickness, and
any profit, losses or other deductions from a Subchapter disability are excluded only to the extent pr ovided by the
S Corporation. Federal Internal Revenue Codes.
9. Premature withdrawals of proceeds from insurance, 4. Une mployment co mpensation, supplement al
pensions, annuities and retirement benefits, including unemployment benefits, welf are reli ef payments,
distributions that are received from qualified trusts upon workmen’s compensation.
termination of employment and receive treatment as 5. Interest from obligations of the United States, such as
gains under the Internal Revenue Service code. Savings Bo nds and T reasury Notes, obligations o f th e
10. Distributions from non-qualified (IRC Section 457) states, or subordinate units of government of states.
plans are subject to City Income Tax. 6. Dividends on an insurance policy.
NON-RESIDENTS 7. Compensation received for service in the armed
A non-resident is subject to tax on all items included in forces of the United States, including Reserves.
total Federal Income which are derived from or 8. Conventional IRA or Roth IRA payments made on
connected with Big Rapids sources as follows: income taxed by the City only. Conventional IRA or Roth
1
1. Salaries, bonuses, wages, commissions, fees, IRA distributions after age 592/ are NOT taxable
vacation pay, severance pay, profit sharing plans and income. Premature distributions of 403B, 401K, IRA or
1
other compensation for services rendered as an Roth IRA before age 592 / are taxable. You must attach
employee in Big Rapids. Vacation pay, holiday pay, copy of your Federal Form and each 1099 form. Federal
sabbatical pay, sick pay, tips, institutional travel and a guidelines are followed.
bonus paid by the employer are deemed to have the 9. Ordinary, necessary, reasonable and
same tax status as the work assignment or work non-reimbursed expenses paid or incurred by an
location and are taxable on the same ratio as the individual in connect ion with the perf ormance of
normal earnings of the employee. services as an employee. Use Form BR2106.
2. Fair mark et value of merchandise or service receive d *Note: Student loan i nterest, tuition, fees and d eductions
as compensations. are not a subtraction.
3. Net profits or loss from the operation of a business *Note: Working interest of gas an d oil leasing is not
or profession or other activity conducted in Big Rapids taxable.
(See Schedule 2 for business allocation.) If Business is
NON-RESIDENTS ONLY
located inside the City limits the entire amount of net
The following items are non-taxable to non-residents
profits are taxable.
only:
4. Net profits from rental of real o r tangible property
1. Interest, dividends and royalty income.
located in Big Rapids.
2. Income from trusts and estates.
5. Personal gains from s ale or excha nge of real o r

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90746_BR_CRA_2009:2 12/9/09 9:43 AM Page 5

Residents Only
Instructions For Preparing Tax Return

First complete the name and address information and Example: Dividend Income Schedule B
be certain that your social security number(s) has Business Income Schedule C
been entered correctly. If your mailing address is Capital Gain Schedule D
different from your actual residence address, please Rents, Royalties Schedule E
note residence address. Farm Income Schedule F

RESIDENCY LINE 3 - SUBTRACTIONS FROM INCOME
Check the resident box if you were a resident for the (Attach Federal Schedules as explanations for the
full taxable year or if the only income for which you are subtractions to your income.)
filing was Big Rapids income earned both as resident Subtractions are listed to correspond with the Federal
and a non-resident, file using the Part Year Form, Form you may have used:
which may be obtained through the Treasurer’s Office Fed. 1040 Tax exempt interest and dividends
or Income Tax Office. Further information is given Taxable refunds of state and local
under “GENERAL INFORMATION”. income tax
Taxable IRA distributions
FILING STATUS Taxable pensions and annuities
Check the appropriate line. Regardless of whether Unemployment compensation
your spouse had earnings for the taxable year, you Taxable social security benefits
may either file jointly or take your spouse as an Moving expenses for moving into
exemption. In either case, both must sign the return. Big Rapids(attach Federal form 3903)
Alimony paid
EXEMPTIONS Qualified Education Programs
Enter the number of allowable exemptions on Line D (Form 1099-Q)
and multiply that number by $600.00, enter the total on Fed. 1040A Tax exempt interest and dividends
line 6. The same rules apply in determining Taxable IRA distributions
exemptions as under the Federal Internal Revenue Taxable pensions and annuities
Code, except that, additional exemptions are NOT Unemployment compensation
allowed for paraplegic, quadriplegic, hemiplegic, Taxable social security benefits
permanently disabled, blind, deaf, or over 65. Fed. 1040EZ No subtractions

If you are NOT claimed as an exemption on Line D on The employee business expenses that are deductible
someone else’s CITY OF BIG RAPIDS return, you are are limited to the following:
entitled to claim yourself. For example, if you are a 1. Expenses of travel, meals and lodging while
student and your parents DO NOT file a CITY OF BIG away from home.
RAPIDS return, you are entitled to claim yourself by 2. Expenses as an outside salesman, who
taking the exemption. works away from his employer’s place of
business. (Does not include driver sales-
LINE 1 - TOTAL INCOME man whose primary duty is service and
Enter “total income” from your Federal Form delivery.)
depending on which Federal Form you used: 3. Expenses of transportation, but not trans-
Fed. 1040 Line 22 portation to and from work.
Fed. 1040A Line 15 4. Expenses reimbursed under an expense
Fed. 1040EZ Line 1 and 2 account or other arrangement with your
If you have no additions or subtractions from income, employer, if the reimbursement has been
carry this amount to Line 5 of BR1040. Attach W-2 included in gross earnings reported.
forms and a copy of your Federal Form.
If “total income” was not taken from your Federal The expense deducted must be offset by an applicable
Form, see “What is Taxable Income” under reimbursement made by the employer that was NOT
“GENERAL INFORMATION”. included in gross earnings. Subtractions for employee
business expenses must be reported on Form BR 2106.
LINE 2 - ADDITIONS TO INCOME
Any additions to income will already be considered if If “total income” was not taken from Federal Form, see
you used “total income” from your Federal Form. “What is Non-Taxable Income” under “GENERAL
Attach Federal Schedules as explanations for the INFORMATION.”
additions on your Federal Form, if applicable.

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90746_BR_CRA_2009:2 12/9/09 9:43 AM Page 6

LINE 4 - IRA DEDUCTIONS                              LINE 16 - TAX DUE
Enter the amount of IRA deduction included on your   If Line 10 (tax due/voluntary contribution) is larger
Federal Form. The City follows the rules and         than Line 15 (total tax payments) enter the
regulations provided by the IRS to govern how much   difference on Line 16.
you are entitled to deduct. The copy of the front of
your Federal Form serves as verification of the      LINE 17 - PENALTY AND INTEREST
deduction being taken.                               Penalty and interest shall be calculated if 1) return is
                                                     being filed after the due date of April 30, 2010 or
LINE 5 - ADJUSTED INCOME                             2) the amount due is more than $100.00 and no
Add lines 1 and 2 less Lines 3 and 4.                estimated payments were made (even if return is
                                                     filed prior to the due date) or 3) the amount due is
LINE 6 - EXEMPTIONS                                  more than $100.00 and estimated payments/tax
Multiply the number of exemptions claimed by         withheld is less than 70% of your 2009 total tax due
$600.00 and enter the result on this Line (from Box  or less than 70% of your 2008 total tax due (even if
D). See “Exemptions” under “GENERAL                  the return is filed prior to the due date.) See
INFORMATION”.                                        Schedule 3.

LINE 7 - TAXABLE INCOME                              LINE 18 - BALANCE DUE
Line 5 less Line 6; if Line 6 is larger than Line 5, Add Line 16 and Line 17, enter total on Line 18. This
enter 0.                                             amount must be paid when filing this return. Make
                                                     your check or money order payable to CITY OF BIG
LINE 8 - TAX                                         RAPIDS and mail your payment and your return to
Multiply the amount on Line 7 by 1% (.01).           CITY OF BIG RAPIDS, TREASURER, 226 NORTH
                                                     MICHIGAN AVENUE, BIG RAPIDS, MICHIGAN 49307
LINE 9 - VOLUNTARY CONTRIBUTION
A voluntary contribution may be made to the Big      LINE 19 - OVERPAYMENT
Rapids Community Pool and/or the Community           If Line 15 (total tax payments) is larger than Line 10
Library.                                             (tax due/voluntary contribution) enter the difference
                                                     on Line 19. Mail your return to CITY OF BIG
LINE 10 - TOTAL OF LINE 8 AND 9                      RAPIDS, INCOME TAX DIVISION, 226 NORTH
                                                     MICHIGAN AVENUE, BIG RAPIDS, MICHIGAN
LINE 11 - BIG RAPIDS TAX WITHHELD                    49307
Enter amount of “local tax” withheld as reflected on
your W-2(s). Attach W-2 form(s).                     BOX A - CREDIT OF 2009 OVERPAYMENT
                                                     Check this box if you want your overpayment to
LINE 12 - ESTIMATED PAYMENTS                         becredited to your 2010 tax.
Enter amount(s) of estimated tax paid for 2009.
                                                     BOX B - REFUND
LINE 13 - CREDIT FROM PREVIOUS YEAR                  Check this box if you want your overpayment
Enter the amount, if any, that was carried forward   refunded to you.
from the previous year.
                                                     SIGN YOUR RETURN
LINE 14 - CREDITS FOR INCOME TAX PAID TO             Be sure that your return is signed. If you are filing
ANOTHER MUNICIPALITY                                 jointly, or taking your spouse as an exemption, both
If you are a Big Rapids resident subject to a city   husband and wife must sign the return.
income tax in another city, you may claim a credit.
This credit may not exceed the tax that a non-       AUDIT OF RETURN
resident of Big Rapids would pay on the same         Each return is audited by the Income Tax Office. The
income earned in Big Rapids. (For example, a Big     attachment of your Federal Form and Schedules is
Rapids resident working in Grand Rapids, with        crucial to expedite processing. If the audit brings forth
Grand Rapids taxable income of $30,000.00, minus     questions about your return, not answered by your
four exemptions of $600.00 each (Big Rapids          Federal Forms or if your return is incomplete, a copy
exemptions amount only) = $27,600.00 x .005 (Big     of the front of your return will be sent back to you.
Rapids non-resident rate only) = $138.00 credit. You
MUST attach a copy of the 2009 City Income Tax       ASSISTANCE
Return you filed with the other city.                For questions not answered in this booklet or
                                                     assistance in preparing your return, call (231) 592-4012
LINE 15 - TOTAL PAYMENTS AND CREDITS                 or visit the Income Tax Office at 226 North Michigan
Add Lines 11, 12, 13 and 14. Enter total on Line 15. Avenue, Big Rapids, Michigan 49307

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90746_BR_CRA_2009:2 12/9/09 9:43 AM Page 7

Non-Residents Only
Instructions For Preparing Tax Return

First complete the name and address information and LINE 2 - ADDITIONS TO INCOME
be certain that your social security number(s) has Attach Federal Schedules as explanations for the
been entered correctly. additions to your income. See “What is Taxable
Income” under “GENERAL INFORMATION”.
Example: Business Income Schedule C
RESIDENCY
Capital Gain Schedule D
Check the non-resident box if you were a non-resident
Rents, Royalties Schedule E
for the full taxable year or if the only income for which
Farm Income Schedule F
you are filing was Big Rapids income earned both as If you file Federal Schedules C, D, or E, but only a
resident and a non-resident, file using the Part Year portion is applicable to the City, see Schedule 2.
Form, which may be obtained through the Treasurer’s
Office or Income Tax Office. Further information is LINE 3 - SUBTRACTIONS FROM INCOME
given under “GENERAL INFORMATION”. (Attach Federal Schedules as explanations for the
subtractions to your income.) See “What is Non-
FILING STATUS Taxable Income” under “GENERAL INFORMATION”.
Check the appropriate line. Regardless of whether
The employee business expenses are deductible, but
your spouse had earnings for the taxable year, you
only to the extent that these expenses are applicable
may either file jointly or take your spouse as an to City taxable income, and are limited to the following:
exemption. In either case, both must sign the return. 1. Expenses of travel, meals and lodging while
away from home.
EXEMPTIONS 2. Expenses as an outside salesman, who works
Enter the number of allowable exemptions on Line D away from his employer’s place of business.
and multiply that number by $600.00, enter the total on (Does not include driver salesman whose
line 6. The same rules apply in determining exemptions primary duty is service and delivery.)
as under the Federal Internal Revenue Code, except 3. Expenses of transportation, but not
transportation to and from work.
that, additional exemptions are NOT allowed for
4. Expenses reimbursed under an expense
paraplegic, quadriplegic, hemiplegic, permanently
account or other arrangement with your
disabled, blind, deaf, or over 65. employer, if the reimbursement has been
included in gross earnings reported.
If you are NOT claimed as an exemption on someone The expense deducted must be offset by an applicable
else’s CITY OF BIG RAPIDS return, you are entitled to reimbursement made by the employer that was NOT
claim yourself. For example, if you are a student and included in gross earnings. Subtractions for employee
your parents DO NOT file a CITY OF BIG RAPIDS business expenses must be reported on Form BR 2106.
return, you are entitled to claim yourself by taking the
exemption. Alimony paid of earnings taxable to the City.

Spouse income earned outside the City.
LINE 1 - TOTAL INCOME
Enter the full amount of gross wages from your W-2(s) LINE 4 - IRA DEDUCTIONS
that reflect Big Rapids income earned. If you As a non-resident, you are only entitled to subtract
performed services both inside and outside of Big the amount of an IRA that was purchased with
Rapids for the same employer, see Schedule 1. If you earnings taxable to the City. If your spouse has no
have no additions or subtractions, carry this amount to income earned through a Big Rapids employer, an
Line 5. Attach W-2 forms and a copy of the front of IRA deduction is not allowed for your spouse on the
City return. For example, if your spouse earned only
your Federal Form. If you are self-employed and have
$5000.00 from a Big Rapids employer and all other
earnings both inside and outside of the City, see
income was earned outside the City, the maximum
Schedule 2. IRA deduction allowable for your spouse is
$5000.00. IRA is deductible to the extent allowed by
Federal Guidelines.

LINE 5 - ADJUSTED INCOME
Add lines 1 and 2 less Lines 3 and 4.

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90746_BR_CRA_2009:2 12/9/09 9:43 AM Page 8

LINE 6 - EXEMPTIONS                                     LINE 18 - BALANCE DUE
Multiply the number of exemptions claimed by            Add Line 16 and Line 17, enter total on Line 18. This
$600.00 and enter the result on this Line (from Box     amount must be paid when filing this return. Make
D). See “Exemptions” under “GENERAL                     your check or money order payable to CITY OF BIG
INFORMATION”.                                           RAPIDS and mail your payment and your return to
                                                        CITY OF BIG RAPIDS, TREASURER, 226 NORTH
LINE 7 - TAXABLE INCOME                                 MICHIGAN AVENUE, BIG RAPIDS, MICHIGAN
Line 5 less Line 6; if Line 6 is larger than Line 5,    49307
enter 0.
                                                        LINE 19 - OVERPAYMENT
LINE 8 - TAX                                            If Line 15 (total tax payments) is larger than Line 10
Multiply the amount on Line 7 by 1/2% (.005).           (tax due/voluntary contribution) enter the difference
                                                        on Line 19. Mail your return to CITY OF BIG
LINE 9 - VOLUNTARY CONTRIBUTION                         RAPIDS, INCOME TAX DIVISION, 226 NORTH
A voluntary contribution may be made to the Big         MICHIGAN AVENUE, BIG RAPIDS, MICHIGAN
Rapids Community Pool and/or the Community              49307
Library.
                                                        BOX A - CREDIT OF 2009 OVERPAYMENT
LINE 10 - TOTAL OF LINE 8 AND 9                         Check this box if you want your overpayment to be
                                                        credited to your 2010 tax.
LINE 11 - BIG RAPIDS TAX WITHHELD
Enter amount of “local tax” withheld as reflected on    BOX B - REFUND
your W-2(s). Attach W-2 form(s).                        Check this box if you want your overpayment
                                                        refunded to you.
LINE 12 - ESTIMATED PAYMENTS
Enter amount(s) of estimated tax paid for 2009.         SIGN YOUR RETURN
                                                        Be sure that your return is signed. If you are filing
LINE 13 - CREDIT FROM PREVIOUS YEAR                     jointly, or taking your spouse as an exemption, both
Enter the amount, if any, that was carried forward      husband and wife must sign the return.
from the previous year.
                                                        AUDIT OF RETURN
LINE 14 - CREDITS FOR INCOME TAX PAID TO                Each return is audited by the Income Tax Office. The
ANOTHER MUNICIPALITY                                    attachment of your Federal Form and Schedules is
Non-applicable to non-residents.                        crucial to expedite processing. If the audit brings
                                                        forth questions about your return, not answered by
LINE 15 - TOTAL PAYMENTS AND CREDITS                    your Federal Forms or if your return is incomplete, a
Add Lines 11, 12, 13 and 14. Enter total on Line 15.    copy of the front of your return will be sent back to
                                                        you.
LINE 16 - TAX DUE
If Line 10 (tax due/voluntary contribution) is larger   ASSISTANCE
than Line 15 (total tax payments) enter the             For questions not answered in this booklet or
difference on Line 16.                                  assistance in preparing your return, call (231) 592-
                                                        4012 or visit the Income Tax Office at 226 North
LINE 17 - PENALTY AND INTEREST                          Michigan Avenue, Big Rapids, Michigan 49307
Penalty and interest shall be calculated if 1) return is
being filed after the due date of April 30, 2010 or 2)
the amount due is more than $100.00 and no
estimated payments were made (even if return is
filed prior to the due date) or 3) the amount due is
more than $100.00 and estimated payments/tax
withheld is less than 70% of your 2009 total tax due
or less than 70% of your 2008 total tax due (even if
the return is filed prior to the due date.) See
Schedule 3.

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90746_BR_CRA_2009:2  12/9/09  9:43 AM  Page 9

                                                                                                                                      ATTACH A COPY OF THE FRONT OF FEDERAL 1040 FORM
                                                                                                  BR 1040                                                                     2009
                                                                                                                                                                CITY OF BIG RAPIDS INCOME TAX
                                                                                                  INDIVIDUAL RETURN                                                                                                                                                                Due Date: April 30, 2010
                                                                                                  A. First Name and Initial                             Last Name                                                         Your Social Security Number                         B. RESIDENCY
                                                                                                                                                                                                                                                                              RESIDENT           
                                                                                                                                                                                                                                                                              Inside City Limits
                                                                                                  If Joint First Name of Spouse                                                                                           Spouse’s Social Security Number                     NON-RESIDENT
                                                                                                                                                                                                                                                                              Township of 
                                                                                                                                                                                                                                                                                Big Rapids       Green
                                                                                                  Present Home Address                                                                                                                                                           Colfax          Grant
                                                                                                                                                                                                                                                                                 Barton          Norwich
                                                                                                  City, State and Zip Code                                                                                                                                                       Home
                                                                                                                                                                                                                                                                                Other_______________________
                                                                                                                                                                                                                                                                              (Please specify)
                                                                                                  C. FILING STATUS                                                                      D. EXEMPTIONS
                                                                                                  A. _____ Single                                                                                                         Number______________________x $600.00 = $______________
                                                                                                  B. _____ Married, Filing Jointly                                                      If you are claimed as a dependent on someone else’s Big Rapids return, check
                                                                                                  C. _____ Married, Filing Separately                                                   this box and do not take the exemption.  
                                                                                                        Spouse’s Name__________________________________________________                 If you are a FSU student with permanent home other than Big Rapids, check
                       PLACE ADDITIONAL FORMS                              BEHIND AND STAPLE HERE       Social Security Number __________________________________________               this box and claim yourself.  

                                                                                                  1.  INCOME:
                                                                                                               A: RESIDENT                      See Instructions
                                                                                                                                                Attach Copy of Federal Form ......................................................................                        1.                                        00
                                                                                                               B: NON-RESIDENT                  Attach Copy of any Federal Schedule(s) that are applicable to your City Return
                                                                                                  2.  ADDITIONS TO INCOME (attach Federal Schedule(s) and Explain) ..........................................................................                             2.                                        00
                                                                                                  3.  SUBTRACTIONS FROM INCOME (attach Federal Schedule(s) and Explain)..............................................................                                     3.                                        00
                                                                                                  4.  IRA DEDUCTIONS .................................................................................................................................................... 4.                                        00
                                                                                                  5.  ADJUSTED INCOME (Add Lines 1 & 2, Subtract 3 & 4)............................................................................................                       5.                                        00
                                                                                                  6.  EXEMPTIONS (From D above) 
                                                                                                  (If you are a student and your parents do not file a City of Big Rapids return, check this box                        and claim yourself) ..............              6.                                        00
                                                                                                  7.  TAXABLE INCOME (Line 5 less Line 6)......................................................................................................................           7.                                        00
                                                                                                  8.  TAX (Multiply amount on Line 7 by one of the following)
                                              STAPLE COPY OF W-2 HERE                                       A: RESIDENT - 1% (.01)
                                                                                                            B: NON-RESIDENT - 1/2% (.005) ................................................................................................................                8.                                        00
                                                                                                            9.  VOLUNTARY CONTRIBUTIONS TO BIG RAPIDS COMMUNITY POOL and/or COMMUNITY LIBRARY ..                                                                          9.                                        00
                                                                                                                                                                                 (Please circle)
                                                                                                  10.  TOTAL OF LINE 8 AND 9........................................................................................................................................      10.                                       00
                                                                                                  PAYMENTS AND TAX CREDITS                                                                                                                                                    O OFFFFIICCEE  UUSSEE  OONNLLYY
                                                                                                  11.  BIG RAPIDS TAX WITHHELD     .............................................................................. 11.                         00                                   P Paayymmeenntt  rreecceeiivveedd
                                                                                                                                                                                                                                                                                   w wiitthh  RReettuurrnn
                                                                                                  12.  2009 ESTIMATED PAYMENTS ............................................................................ 12.                               00
                                                                                                                                                                                                                                                                              _____________________
                                                                                                  13.  CREDIT FROM PREVIOUS YEAR OVER PAYMENT...................................................... 13.                                       00                              _____________________
                                                                                                  14.  CREDITS FORINCOMETAX PAID TO ANOTHER    MICHIGANMUNICIPALITY(RESIDENTSONLY) .... 14.                                                   00                              _____________________
                                                                                                  15.  TOTAL PAYMENTS AND CREDITS (Add Lines 11, 12, 13 & 14)........................................................................................                     15.                                       00
                                                                                                  16.  TAX DUE (Line 10 larger than Line 15) ....................................................................................................................         16.                                       00
                                                                                                  17.  PENALTY AND INTEREST (Schedule 3)..................................................................................................................                17.                                       00
                                                                                                  18.  BALANCE DUE (Add Lines 16 and 17) ..................................................................................................................               18.                                       00
                                                                                                  19.  OVERPAYMENT (Line 15 is larger than Line 10 ......................................................................................................                 19.                                       00
                                                                                                             Amount on Line 19 is to be (CHECK ONE BOX ONLY)
                                              ENCLOSE CHECK - DO NOT STAPLE
                                                                                                                                                                A.    Credited to 2010               B.     Refunded to You
                                                                                                  I declare, under penalty of perjury, that the information on this return and attachments is true and complete.
                                                                                                            I authorize the City to discuss my                          DO NOT discuss my                                 I declare, under penalty of perjury, that this return
                                                                                                            claim and attachments with my                               claim with my preparer.                           is based on all information of which I have knowledge.
                                                                                                            preparer
                                              SIGN                                                Filer’s Signature ______________________________________________ Date __________________                                PREPARER’S SIGNATURE & ADDRESS
                                                                                                                    Birthdate______________________________
                                                                                                  Spouse’s Signature ____________________________________________ Date __________________
                                                                                                                    Birthdate______________________________                                                               Phone (           )_______________________________
                                                                                                             MAIL YOUR RETURN FOR REFUND TO: CITY OF BIG RAPIDS, INCOME TAX DIVISION, 226 NORTH MICHIGAN AVE., BIG RAPIDS, MI 49307
                                                                                                            MAIL YOUR RETURN FOR PAYMENT TO: CITY OF BIG RAPIDS, TREASURER’S OFFICE, 226 NORTH MICHIGAN AVE., BIG RAPIDS, MI 49307

- 36 -

90746_BR_CRA_2009:2 12/9/09 9:43 AM Page 10

BR 1040 Taxpayer Name ________________________
Page 2
Social Security # ______________________

2009

CITY OF BIG RAPIDS INCOME TAX

SCHEDULE 1

This schedule applies to NON-RESIDENTS ONLY on income partially earned in the City of Big Rapids, verifi-
cation MUST be accompanied by statement, based on 261 days per year or explanation for difference,
signed and dated each year by employer only.

If both Husband and Wife have income subject to allocation, figure them separately.

A. Wages subject to allocation from W-2 A. __________________________
B. Percent earned as taxable income in Big Rapids to
non-residents per instructions (Attach statement from employer) B. __________________________
C. Multiply Line A by Line B C.__________________________
D. Add all other W-2 income not allocated D.__________________________
E. Total wages subject to Big Rapids City Tax E. __________________________
(Add Line C and D). Enter the amount from Line E
on Page 1, Line 1.

SCHEDULE 2

This schedule applies to NON-RESIDENTS ONLY
and is relative to SCHEDULE C, D, OR E.

A. Income from applicable Federal Schedule A. __________________________
B. Percent earned in Big Rapids B. __________________________
C. Multiply Line A by Line B C.__________________________
Enter BR 1040, Line 2

SCHEDULE 3

This schedule applies to both residents and non-residents who file their return after the due date of April 30, 2010
and owe tax liability.

A. Interest - .0001164 per day A. __________________________
B. Penalty - 1 % of the amount of the unpaid tax for each
month or fraction thereof not to exceed a total penalty of
25% of the unpaid tax. B. __________________________
C. Total penalty and interest, but must pay a minimum of $2.00
Enter on BR 1040, Line 17 C.__________________________

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90746_BR_CRA_2009:2  12/9/09  9:43 AM  Page 11

                                                                                                                                REFER TO INSTRUCTIONS ON BACK TO SEE WHO CAN USE THIS FORM
                                                                                                                                ATTACH A COPY OF THE FRONT OF FEDERAL 1040 FORM
                                                                                            BR 1040EZ
                                                                                            INDIVIDUAL RETURN                                        2009
                                                                                                                                                                                                                                                                       Due Date: April 30, 2010
                                                                                            A. First Name and Initial              Last Name                                                   Your Social Security Number                                        B. RESIDENCY
                                                                                                                                                                                                                                                                  RESIDENT           
                                                                                                                                                                                                                                                                  Inside City Limits
                                                                                            If Joint First Name of Spouse                                                                      Spouse’s Social Security Number                                    NON-RESIDENT
                                                                                                                                                                                                                                                                  Township of 
                                                                                                                                                                                                                                                                    Big Rapids       Green
                                                                                            Present Home Address                                                                                                                                                     Colfax          Grant
                                                                                                                                                                                                                                                                     Barton          Norwich
                                                                                            City, State and Zip Code                                                                                                                                                 Home
                                                                                                                                                                                                                                                                    Other_______________________
                                                                                                                                                                                                                                                                  (Please specify)
                                                                                            C. FILING STATUS                                                                                   D. EXEMPTIONS
                                                                                            A. _____ Single                                                                                    Number______________________x $600.00 = $______________
                                                                                            B. _____ Married, Filing Jointly                                                                   If you are claimed as a dependent on someone else’s Big Rapids return, check
                                                                                            C. _____ Married, Filing Separately                                                                this box and do not take the exemption.  
                       PLACE ADDITIONAL FORMS                        BEHIND AND STAPLE HERE Spouse’s Name__________________________________________________                                    If you are a FSU student with permanent home other than Big Rapids, check
                                                                                            Social Security Number __________________________________________                                  this box and claim yourself.  

                                                                                            1.  Total Wages, Salaries, and Tips......................................................................................................................         1.                                00

                                                                                            2.  Interest and/or Dividends Income ..................................................................................................................           2.                                00

                                                                                            3.  Exemptions (From D above)       ............................................................................................................................  3.                                00
                                                                                            (if you are a student and your parents do not file a City of Big Rapids return, check this box   and claim yourself)

                                                                                            4.  Taxable Income (Line 1 + Line 2 - Line 3) ......................................................................................................              4.                                00

                                                                                            5.  Tax (multiply amount on Line 4 by one of the following)..................................................................................                     5.                                00
                                              STAPLE COPY OF W-2 HERE
                                                                                            A: RESIDENT ONLY -1% (.01)
                                                                                            B: NON-RESIDENT ONLY - 1/2% (.005)

                                                                                            6.  Voluntary Contribution to BIG RAPIDS COMMUNITY POOL and/or COMMUNITY LIBRARY (Please circle) ..                                                               6.                                00

                                                                                            7.  Total of Lines 5 and 6 ....................................................................................................................................   7.                                00
                                                                                                                                                                                                                                                                       OFFICE USE ONLY
                                                                                                                                                                                                                                                                       Payment received
                                                                                            8.  Tax Withheld                                                                               00                                                                                     with Return
                                                                                            2009 Estimated Payments                                                                        00                                                                     ______________________
                                                                                                                                                                                                                                                                  ______________________
                                                                                            Credit from previous year over payment                                                         00                                                                     ______________________
                                                                                                                                                     Total Payments                                                            00
                                                                                            9.  Tax Due (Line 7 minus Line 8) ........................................................................................................................        9.                                00

                                                                                            10.  Penalty and Interest......................................................................................................................................   10.                               00

                                              ENCLOSE CHECK - DO NOT STAPLE                 11.  Balance Due ................................................................................................................................................ 11.                               00
                                                                                            12.  Overpayment /Amount of Refund (Line 8 minus Line 7)................................................................................                          12.                               00
                                                                                            I declare, under penalty of perjury, that the information on this return and attachments is true and complete.
                                                                                            I authorize the City to discuss my                       DO NOT discuss my                                            I declare, under penalty of perjury, that this return
                                                                                            claim and attachments with my                            claim with my preparer.                                      is based on all information of which I have knowledge.
                                                                                            preparer
                                                                                            Filer’s Signature ______________________________________________ Date __________________                              PREPARER’S SIGNATURE & ADDRESS

                                                                                                             Birthdate______________________________

                                                                     SIGN                   Spouse’s Signature ____________________________________________ Date __________________
                                                                                                             Birthdate______________________________                                                              Phone (            )_______________________________
                                                                                            MAIL YOUR RETURN FOR REFUND TO: CITY OF BIG RAPIDS, INCOME TAX DIVISION, 226 NORTH MICHIGAN AVE., BIG RAPIDS, MI 49307
                                                                                            MAIL YOUR RETURN FOR PAYMENT TO: CITY OF BIG RAPIDS, TREASURER’S OFFICE, 226 NORTH MICHIGAN AVE., BIG RAPIDS, MI 49307

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90746_BR_CRA_2009:2  12/9/09  9:43 AM  Page 12

          INSTRUCTIONS FOR FORM BR 1040EZ

WHO CAN   Use This Form If:
USE THIS
FORM
          You were a Resident of Big Rapids for all of 2009 with income from wages,
          interest or dividends.

          You were a Non-Resident of Big Rapids for all of 2009 with wages earned in Big
          Rapids and none of the earnings from Big Rapids employees is excluded from
          Big Rapids Income Tax.

RESIDENCY Place a check mark in the Resident or Non-Resident township area. A part-time
STATUS    residency of Big Rapids cannot use this form.

INCOME    If you have income on your Federal Income Tax Return that is not taxable by
          Big Rapids, use Form BR 1040.

LINE 1    Total Wages, Salaries and Tips.
          Residents: Total from Box 1 of all your W-2 forms.
          Non-Residents: Total from Box 1 of all the W-2 forms for work done in the City
          of Big Rapids.

          Attach your W-2 forms on the front of form BR 1040EZ

LINE 2
          Residents: Report all taxable interest and dividend income.
          Non-Residents: Leave blank, interest and dividend income is not taxable to a
          Non-Resident.

LINE 10
          This schedule applies to both residents and non-residents who file their return
          after the due date of April 30, 2010 and owe tax liability.

          A. Interest - .0001164 per day                             A.________________
          B. Penalty - 1% of the amount of the unpaid
          tax for each month of fraction thereof not
          to exceed a total penalty of 25% of the
          unpaid tax.                                                B.________________
          C. Total penalty and interest, but must pay a 
          minimum of $2.00
          Enter on BR 1040EZ, Line 10                                C. ______________

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90746_BR_CRA_2009:2  12/9/09  9:43 AM  Page 13

                                                                                                                                        ATTACH A COPY OF THE FRONT OF FEDERAL 1040 FORM
                                                                                                                                                                    PART YEAR FORM
                                                                           BR 1040P
                                                                           INDIVIDUAL RETURN                                                                                      2009                                                                                                   Due Date: April 30, 2010
                                                                                                                                                          CITY OF BIG RAPIDS INCOME TAX
                                                                                                  A. First Name and Initial                            Last Name                                                            Your Social Security Number                             B. RESIDENCY
                                                                                                                                                                                                                                                                                    RESIDENT           
                                                                                                                                                                                                                                                                                    Inside City Limits
                                                                                                  If Joint First Name of Spouse                                                                                             Spouse’s Social Security Number                         NON-RESIDENT
                                                                                                                                                                                                                                                                                    Township of 
                                                                                                                                                                                                                                                                                      Big Rapids       Green
                                                                                                  Present Home Address                                                                                                                                                                 Colfax          Grant
                                                                                                                                                                                                                                                                                       Barton          Norwich
                                                                                                                                                                                                                                                                                       
                                                                                                  City, State and Zip Code                                                                                                                                                               Home
                                                                                                                                                                                                                                                                                      Other_______________________
                                                                                                                                                                                                                                                                                    (Please specify)
                                                                                                  C. FILING STATUS                                                                                                      D. EXEMPTIONS
                                                                                                  A. _____ Single                                                                                                           Number______________________x $600.00 = $______________
                                                                                                  B. _____ Married, Filing Jointly                                                                                      If you are claimed as a dependent on someone else’s Big Rapids return, check
                                                                                                  C. _____ Married, Filing Separately                                                                                   this box and do not take the exemption.               If you are a FSU student with per-
                                                                                                                                                                                                                        manent home other than Big Rapids, check this box and claim yourself.  
                       PLACE ADDITIONAL FORMS                              BEHIND AND STAPLE HERE       Spouse’s Name__________________________________________________
                                                                                                        Social Security Number __________________________________________
                                                                                                                                                                                                                           Dates From:______________________                    Dates From:______________________
                                                                                                                                                                                                                            To:______________________                                    To:______________________
                                                                                                  Use this form only if you had taxable income during 2009
                                                                                                  Both as a Resident and Non-Resident                                                                                       ALL INCOME WHILE A                                      PORTION OF INCOME EARNED IN
                                                                                                                                                                                                                            BIG RAPIDS RESIDENT                                          BIG RAPIDS WHILE
                                                                                                                                                                                                                                                                                         A NON-RESIDENT
                                                                                                  1.  GROSS WAGES (Attach W-2)................................................................................          1.                                           00                                                   00
                                                                                                  2.  ADDITIONS (Attach Schedule(s) and Explain) ........................................................               2.                                           00                                                   00
                                                                                                  3.  SUBTRACTIONS (Attach Schedules(s) and Explain) ..............................................                     3.                                           00                                                   00
                                                                                                  4. TOTAL INCOME - BOTH COLUMNS (add Lines 1, 2 and Less 3) ..........................                                 4.                                           00                                                   00
                                                                                                  5.  LESS EXEMPTIONS - Multiply Number of Exemptions claimed by $600.00,                                               5.                                           00                                                   00
                                                                                                  enter in Column 1 (if more than Line 4, carry excess to Column 2) ........................
                                                                                                  (if you are a student and your parents do not file a City of Big Rapids return, 
                                                                                                  check this box   and claim yourself)
                                                                                                  6.  TAXABLE INCOME - LINE 4, less Line 5................................................................              6.                                           00                                                   00
                                              STAPLE COPY OF W-2 HERE                             7.  TAX - Residential Income: Multiply Line 6, Column 1 by 1% (.01)..................................................................................              7.                                                   00
                                                                                                  8.  TAX - Non-Residential Income: Multiply Line 6, Column 2 by 1/2% (.005) ....................................................................                    8.                                                   00
                                                                                                  9.  VOLUNTARY CONTRIBUTION TO BIG RAPIDS COMMUNITY POOL and/or COMMUNITY LIBRARY                                                   (Please circle)                 9.                                                   00
                                                                                                  10.  TOTAL TAX - Add Lines 7, 8 and 9 ............................................................................................................................ 10.                                                  00
                                                                                                  PAYMENTS AND TAX CREDITS                                                                                                                                                          O OFFFFIICCEE  UUSSEE  OONNLLYY
                                                                                                  11.  BIG RAPIDS TAX WITHHELD ......................................................................................   11.                                          00                  P Paayymmeenntt  rreecceeiivveedd
                                                                                                                                                                                                                                                                                                w wiitthh  RReettuurrnn
                                                                                                  12.  2009 ESTIMATED PAYMENTS     .................................................................................... 12.                                          00
                                                                                                                                                                                                                                                                                    _____________________
                                                                                                  13.  CREDIT FROM PREVIOUS YEAR OVER PAYMENT ..............................................................            13.                                          00             _____________________
                                                                                                  14.  CREDITS FORINCOME AXT PAID TO ANOTHER  MICHIGANMUNICIPALITY(RESIDENTSONLY) ..........                            14.                                          00             _____________________

                                                                                                  15.  TOTAL PAYMENTS AND CREDITS (Add Lines 11, 12, 13 & 14) ......................................................................................................            15.                                       00
                                                                                                  16.  TAX DUE (Line 10 larger than Line 15) .................................................................................................................................. 16.                                       00
                                                                                                  17.  PENALTY AND INTEREST (Schedule 3 of BR 1040 Return) ..................................................................................................                   17.                                       00
                                                                                                  18.  BALANCE DUE (Add Lines 16 and 17) ..................................................................................................................................     18.                                       00
                                                                                                  19.  OVERPAYMENT (Line 15 is larger than Line 10 ....................................................................................................................         19.                                       00
                                                                                                             Amount on Line 19 is to be (CHECK ONE BOX ONLY)
                                              ENCLOSE CHECK - DO NOT STAPLE
                                                                                                                                                          A.    Credited to 2010               B.                                Refunded to You
                                                                                                  I declare, under penalty of perjury, that the information on this return and attachments is true and complete.
                                                                                                           I authorize the City to discuss my                                     DO NOT discuss my                                  I declare, under penalty of perjury, that this return
                                                                                                           claim and attachments with my                                          claim with my preparer.                            is based on all information of which I have knowledge.
                                                                                                           preparer
                                              SIGN                                                Filer’s Signature ______________________________________________ Date __________________                                           PREPARER’S SIGNATURE & ADDRESS
                                                                                                                   Birthdate______________________________
                                                                                                  Spouse’s Signature ____________________________________________ Date __________________
                                                                                                                   Birthdate______________________________                                                                           Phone (           )_______________________________
                                                                                                            MAIL YOUR RETURN FOR REFUND TO: CITY OF BIG RAPIDS, INCOME TAX DIVISION, 226 NORTH MICHIGAN AVE., BIG RAPIDS, MI 49307
                                                                                                            MAIL YOUR RETURN FOR PAYMENT TO: CITY OF BIG RAPIDS, TREASURER’S OFFICE, 226 NORTH MICHIGAN AVE., BIG RAPIDS, MI 49307

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                                          INSTRUCTIONS FOR PART YEAR FORM

If you earned part of your income while a resident and you      credit). You MUST attach a copy of the 2009 City Income Tax
earned part of your income in Big Rapids while a non-           Return you filed with the other city.
resident, complete this form.
                                                                LINE 15 - TOTAL PAYMENTS AND CREDITS
COLUMN 1 - LINES 1, 2 AND 3                                     Add Lines 11, 12, 13 and 14. Enter the results on this Line.
Include these items as though filing as a resident but only that
portion while a resident (See Resident instructions).           LINE 16 - TAX DUE
                                                                If Line 10 is larger than Line 15, enter the difference on this
COLUMN 2 - LINES 1, 2 AND 3                                     Line.
Include these items as though filing as a non-resident but
only that portion that was Big Rapids earned income while a     LINE 17 - PENALTY AND INTEREST
non-resident. (See Non-Resident instructions).                  Penalty and interest shall be calculated if 1) return is being
                                                                filed after the due date of April 30, 2010 or 2) the amount
Line 4 - Total Income                                           due is more than $100.00 and no estimated payments were
Add Lines 1 and 2 less Line 3 for Both Columns.                 made (even if return is filed prior to the due date) or 3) the
                                                                amount due is more than $100.00 and the estimated
LINE 5 - EXEMPTIONS                                             payments/tax withheld is less than 70% of your 2009 total tax
Multiply your exemptions by $600.00 and enter in Column 1.      due or less than 70% of your 2008 total tax due (even if the
If Column 1, Line 5 (Exemption Deduction) is larger than Line   return is filed prior to the due date).
4 (Total Income), carry excess to Column 2, Line 5.
                                                                LINE 18 - BALANCE DUE
LINE 6 - TAXABLE INCOME                                         Add Lines 16 and 17, enter the total on Line 18. This amount
Subtract Line 5 from Line 4 and enter result on Line 6 for      must be paid when filing the return. Make your check or
Both Columns.                                                   money order payable to: CITY OF BIG RAPIDS. Mail your
                                                                return to TREASURER’S OFFICE, 226 NORTH MICHIGAN
LINE 7 - TAX ON RESIDENT INCOME                                 AVENUE, BIG RAPIDS, MI 49307.
Multiply the Taxable Income in Column 1, Line 6 by 1% (.01)
and enter the result on this Line.                              LINE 19 - OVERPAYMENT
                                                                If Line 15 is larger than Line 10, enter the difference on this
LINE 8 - TAX ON NON-RESIDENT INCOME                             Line. Mail your return to: CITY OF BIG RAPIDS INCOME
Multiply the Taxable Income in Column 2, Line 6 by 1/2% or      TAX DIVISION, 226 NORTH MICHIGAN AVENUE, BIG
(.005) and enter the result on this Line.                       RAPIDS, MI 49307.

LINE 9 - VOLUNTARY CONTRIBUTION to Big Rapids                   BOX A - CREDIT OF 2009 OVERPAYMENT
Community Pool and/or Community Library.                        Check this box if you want your overpayment credited to your
                                                                2009 tax.
LINE 10 - TOTAL TAX
Add Lines 7, 8 and 9 and enter the result on this Line.         BOX B - REFUND
                                                                Check this box if you want your overpayment refunded to
LINE 11 - BIG RAPIDS TAX WITHHELD                               you.
Enter the amount of “Local Tax” withheld as reflected on your
W-2(s). Attach W-2(s) form(s).                                  SIGN YOUR RETURN
                                                                Be sure that your return is signed. If you are filing jointly, or
LINE 12 - ESTIMATED PAYMENTS                                    taking your spouse as an exemption, both husband and wife
Enter the amount(s) of estimated tax paid for 2009.             must sign the return.

LINE 13 - CREDIT FROM PREVIOUS YEAR                             AUDIT OF RETURN
Enter the amount, if any, that was carried forward from the     Each return is audited by the Income Tax Office. The
previous year.                                                  attachment of your Federal Form and Schedules is crucial to
                                                                expedite processing. If the audit brings forth questions about
LINE 14 - CREDITS FOR INCOME TAX PAID TO ANOTHER                your return not answered by your Federal Forms or if your
MUNICIPALITY.                                                   return is incomplete, a copy of the front of your return will be
If you are a Big Rapids resident subject to a city income tax   sent back to you.
in another city, you may claim a credit. This credit may not
exceed the tax that a non-resident of Big Rapids would pay      ASSISTANCE
on the same income earned in Big Rapids. (For example, a        For questions not answered in the booklet or assistance in
Big Rapids resident working in Grand Rapids, with Grand         preparing your return, call (231) 592-4012 or visit the Income
Rapids taxable income of $30,000.00, minus four exemptions      Tax Office at 226 North Michigan Avenue, Big Rapids,
of $600.00 each (Big Rapids exemptions amount only) =           Michigan.
$27,600.00 x .005 (Big Rapids non-resident rate only = $138.00

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90746_BR_CRA_2009:2  12/9/09  9:43 AM  Page 15

                                              CITY OF BIG RAPIDS
                    APPLICATION FOR EXTENSION

Name __________________________________________________________________________

Address (Number and Street) ________________________________________________________

City, State, Zip ____________________________________________________________________

Social Security # or
Federal I.D.# ____________________________________________________________________

Check type of return to be filed and attach Federal extension

                    ___________BR 1040 Individual                Attach Federal Form 4868

                    ___________BR 1120 Corporation               Attach Federal Form 7004

                    ___________BR 1065 Partnership               Attach Federal Form 7004

Taxable Year of _____________________ or Fiscal Year of______________ to ________________

Extension requested until_________________________________________, to file the Big Rapids
Income Tax Return (Not to exceed six months).

1.                  Your Tax Liability  $_____________________

2.                  Your Record of Credits
                    (a) Overpayments credited from prior year ______________
                    (b) Estimated tax payments for the year      ______________
                    (c) Withholding for the current year         ______________
                    (d) Tentative tax paid with application      ______________

                    TOTAL CREDITS                                $______________

                                              BALANCE   =                                $          -0-

An extension is not a request for additional time to pay tax due.
The filing of federal Forms 4868 and 7004, Application for Automatic Extension of Time to File U.S. Income Tax return, with the
Internal Revenue Service, does not grant an extension of time to file a city income tax return. An Application for an Extension
of Time to File a City Income Tax Return must be filed.

CITY INCOME TAX ORDINANCE - Sec. 64 Paragraph 2
Penalty  or  Interest  shall  not  be  assessed  if  the  return  is  filed  and  the  final  tax  paid  within  the  extended  time  and  all 
other  filing  and  payment  requirements  of  this  ordinance  are  satisfied,  and  the  estimated  tax  paid  equals  70%  or 
more  of  the  tax  shown  due  on  the  final  return,  or  70%  or  more  of  the  tax  shown  due  on  the  return  for  the  preceding
taxable year.

   Taxpayer/Authorized Signature                          Taxpayer/Authorized Signature

   Date

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90746_BR_CRA_2009:2 12/9/09 9:43 AM Page 17

City of Big Rapids

AMENDED
Income Tax Form

**** A COPY OF THE ORIGINAL MUST ACCOMPANY THIS AMENDED RETURN****

Year Being Amended ____________________ Social Security
or Federal I.D.# ________________________________
Type of Return __________________________

Name ____________________________________________________

Current Address ____________________________________________

____________________________________________

Reason for Amendment (including calculations) __________________________________________________________

Original Tax Refunded __________________

Additional Amount to be Refunded __________________

Additional Amount Owed __________________
Interest - .0001164 per day. __________________

Penalty - 1% per month not to exceed
25% of tax owed or a combined
minimum of $2.00 __________________

TOTAL TAX DUE __________________

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90746_BR_CRA_2009:2 12/9/09 9:43 AM Page 19

INSTRUCTIONS FOR CITY OF BIG RAPIDS DECLARATION OF ESTIMATED INCOME TAX

1. WHO MUST MAKE A DECLARATION

2. WHEN AND WHERE TO FILE DECLARATION AND PAY TAX

3. PENALTIES AND INTEREST

THE FILING OF A DECLARATION OF ESTIMATED TAX DOES NOT EXCUSE THE TAXPAYER
FROM FILING AN ANNUAL RETURN EVEN THOUGH THERE IS NO CHANGE IN THE DECLARED
TAX LIABILITY.

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90746_BR_CRA_2009:2  12/9/09  9:43 AM  Page 21

       BR 1120ES                                      Income Tax Division
                     or                                 CITY OF BIG RAPIDS                                 VOUCHER 4
                     BR 1040ES              Estimated Tax Declaration - Voucher                          4th Quarter
       CITY OF BIG RAPIDS                                         For the Year 2010               (Calendar Year - Due Jan. 30, 2011)
                     To be used for making declaration and payment
Employee Federal I.D. # or Social Security #
Name                                                                                Estimated Tax          $__________________
Address
                                                                                    Amount of this payment $__________________
City, State, Zip Code

       Return this voucher with check or money order payable to:                    __________________________________________
                        “City of Big Rapids” and mail to
       Treasurer’s Office, 226 N. Michigan, Big Rapids, Michigan 49307              SIGN HERE

       BR 1120ES                                      Income Tax Division
                     or                                 CITY OF BIG RAPIDS                                 VOUCHER 3
                     BR 1040ES              Estimated Tax Declaration - Voucher                          3rd Quarter
       CITY OF BIG RAPIDS                                         For the Year 2010               (Calendar Year - Due Sept. 30, 2010)
                     To be used for making declaration and payment
Employee Federal I.D. # or Social Security #
Name                                                                                Estimated Tax          $__________________
Address
                                                                                    Amount of this payment $__________________
City, State, Zip Code

       Return this voucher with check or money order payable to:                    __________________________________________
                        “City of Big Rapids” and mail to
       Treasurer’s Office, 226 N. Michigan, Big Rapids, Michigan 49307              SIGN HERE

       BR 1120ES                                      Income Tax Division
                     or                                 CITY OF BIG RAPIDS                                 VOUCHER 2
                     BR 1040ES              Estimated Tax Declaration - Voucher                          2nd Quarter
       CITY OF BIG RAPIDS                                         For the Year 2010               (Calendar Year - Due June 30, 2010)
                     To be used for making declaration and payment
Employee Federal I.D. # or Social Security #
Name                                                                                Estimated Tax          $__________________
Address
                                                                                    Amount of this payment $__________________
City, State, Zip Code

       Return this voucher with check or money order payable to:                    __________________________________________
                        “City of Big Rapids” and mail to
       Treasurer’s Office, 226 N. Michigan, Big Rapids, Michigan 49307              SIGN HERE

       BR 1120ES                                      Income Tax Division
                     or                                 CITY OF BIG RAPIDS                                 VOUCHER 1
                     BR 1040ES              Estimated Tax Declaration - Voucher                          1st Quarter
       CITY OF BIG RAPIDS                                         For the Year 2010               (Calendar Year - Due April 30, 2010)
                     To be used for making declaration and payment
Employee Federal I.D. # or Social Security #
Name                                                                                Estimated Tax          $__________________
Address
                                                                                    Amount of this payment $__________________
City, State, Zip Code

       Return this voucher with check or money order payable to:                    __________________________________________
                        “City of Big Rapids” and mail to
       Treasurer’s Office, 226 N. Michigan, Big Rapids, Michigan 49307              SIGN HERE

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